From the Margins to the HIV Establishment

Watching How to
Survive a Plague, I was struck by the footage from the Sixth International
Conference on AIDS, which shows some of the same people at the conference as
working today in HIV treatment, policy, research and programming, both among
the government research wonks and the activists, some of whom have become
wonks. This footage also includes sex workers, who have been part of the gay
rights movement and AIDS activism from the beginning. Members of the AIDS
Coalition to Unleash Power (ACT UP) and Prostitutes of New York (PONY)
overlapped and held different roles in the different organizations. This aspect
of HIV activism is sometimes neglected, sometimes to save the positions now
held by former sex workers, out of not knowing everyone's whole lives, and
sometimes perhaps out of stigma an discrimination.

Sex workers have supported activism in response to HIV out
of need, and as part of ACT UP and other organizations. Sex workers and gay
rights activists were already mingling and moonlighting together prior to the
advent of HIV. The Stonewall riot included many people who sold sex among the
cross-dressers and others at the Stonewall Inn. A few years earlier, many
transgender sex workers were part of the riot at Compton's Café in San
Francisco. These were seminal events of the gay rights movement.

Seeing the movie is to be transported to another time, an
era in which HIV patients were rejected by health care providers, hospitals
and funeral parlors. A world in which Senator Jesse Helms condemned gay
people for "sodomy" and wanted gay and lesbian people to "keep their mouths
shut." A world in which it was acceptable for Pat Buchanan to use the threat of
the virus to tell people to be celibate and when George Herbert Walker Bush
told people to change their behavior, essentially parroting Buchanan in telling
gay people to stop having sex. Since the late 1980s and early 1990s when this
footage was taken, this has changed and gay people are more visible and hold
positions of respect and power in our society. The AIDS pandemic galvanized a
movement because this was a matter of life and death. Now that there is
successful treatment, it is easy to forget that much of a generation of gay men
were killed by the virus between 1981 and 1996, affecting the lives of everyone
who loved them. The fact that the hateful statements of Bush and Helms are
unthinkable in US politics today is in great part due to the work of ACT UP and
other activists, including sex workers who have been part of AIDS activism all
along.

How to Survive inspired me and depressed me. Seeing what a group
of motivated people accomplished fairly quickly is encouraging. Seeing that a
small group within the affected populations still bears disproportionate burden
of HIV, in the US in general, in places with more severe epidemics such as
specific urban centers like Harlem and Washington, DC, and in places where
marriage is considered a risk factor because HIV prevalence is so high, mostly
in but not limited to countries in Southern Africa. Key populations at higher
risk of HIV include not only men who have sex with men but also sex workers and
people who inject drugs. Sex workers and people who use drugs have not made the
same strides as gay people have in many places; many sex workers and people who like drugs
hide these activities. They do so with good reason: they could lose their jobs,
their homes and custody of their children. These are all things that gay men
and women faced here until very recently.

I was depressed when thinking that sex workers and drug
users are still fighting to be at the table in the ways that men who have sex
with men have achieved at least in some places. Even though sex workers and
people who use drugs have been part of mobilizing against HIV for thirty years,
they have not had the same support from the people who have become mainstream
AIDS advocates in the same way since men who have sex with men have been able
to affect the HIV pandemic.

There are sterling exceptions, and many are in this
important movie. They are role models for a movement for the necessary movement
to bring other remaining marginalized groups to the discussions that form
policy on HIV, which affects their lives in the form of the disproportionate HIV
burden they carry, which is now in this country and elsewhere becoming more
prevalent among women in general. One clip includes a man in a clinical trial
at a demonstration asked about the trial, and the fact that there were no
people of color and no women in the trial. This has changed, and is critical
now that we know that African
American women in the US are five times as likely as other women to contract
HIV. Gay men fought to be present at discussions of HIV research and to
help set the agenda; it's necessary that the coalitions working on these issues
make the effort to include all affected communities, especially sex workers and
people who use drugs.

1 Comment

Comments on Melissa Ditmore's blog entry "From the Margins to the HIV Establishment"

I am overjoyed to read such an intelligent article which includes the less-than-pretty demographic of survivors. As a former prostitute and drug addict this article was especially meaningful for me. Thank you for daring to talk honestly about an all too often unrepresented and invisible group of people.